商业健康保险市场中医疗机构与保险公司关系的博弈分析

A game-theoretic approach to analysis of interaction between medical institution and insurance company in commercial health insurance market

为促进我国健康保险市场的平稳发展,对医疗机构与健康保险公司之间的博弈关系进行了分析,结合当前实际,建议政府应当大力推进相关制度基础设施建设,这包括协助建立医疗机构—保险公司信息共享平台、推进医药分家制和费用预付制以及加大对违规医疗机构人员的执法力度等。

A game-theoretic analysis of the interaction between medical institutions and heahh insurancecompanies was conducted to promote the development of the health insurance business. Several institutional infrastructure were proposed to be constructed, including the construction of information sharing platform between medical institutions and insurance companies, the separation of medical service and pharmaceutical sales together with the spread of the prepaid system, and the strengthening of the law enforcement against the fraud.